Clinical Characteristics and Outcomes of Hospitalized and Critically …

Chao, J. Y., Derespina, K. R., Herold, B. C., Goldman, D. L., Aldrich, M., Weingarten, J., … & Medar, S. S. (2020). Clinical characteristics and outcomes of hospitalized and critically ill children and adolescents with coronavirus disease 2019 (COVID-19) at a Tertiary Care Medical Center in New York City. The Journal of Pediatrics.

Objective
To describe the clinical profiles and risk factors for critical illness in hospitalized children and adoles-cents with coronavirus disease 2019 (COVID-19).

Study design
Children 1 month to 21 years of age with COVID-19 from a single tertiary care children’s hospitalbetween March 15 and April 13, 2020 were included. Demographic and clinical data were collected.

Results
In total, 67 children tested positive for COVID-19; 21 (31.3%) were managed as outpatients. Of 46admitted patients, 33 (72%) were admitted to the general pediatric medical unit and 13 (28%) to the pediatric inten-sive care unit (PICU). Obesity and asthma were highly prevalent but not significantly associated with PICU admis-sion (P= .99). Admission to the PICU was significantly associated with higher C-reactive protein, procalcitonin, andpro-B type natriuretic peptide levels and platelet counts (P< .05 for all). Patients in the PICU were more likely torequire high-flow nasal cannula (P= .0001) and were more likely to have received Remdesivir through compas-sionate release (P< .05). Severe sepsis and septic shock syndromes were observed in 7 (53.8%) patients in thePICU. Acute respiratory distress syndrome was observed in 10 (77%) PICU patients, 6 of whom (46.2%) requiredinvasive mechanical ventilation for a median of 9 days. Of the 13 patients in the PICU, 8 (61.5%) were dischargedhome, and 4 (30.7%) patients remain hospitalized on ventilatory support at day 14. One patient died after with-drawal of life-sustaining therapy because of metastatic cancer.

Conclusions
We describe a higher than previously recognized rate of severe disease requiring PICU admission inpediatric patients admitted to the hospital with COVID-19.(J Pediatr 2020;223:14-9).

Disponível Em: <https://www.ncbi.nlm.nih.gov/>